Evaluation of an alternative transport initiative in Perth, Western Australia 2000-2004

Issue addressed: Perth Western Australia, has the highest proportion of per capita car ownership in Australia. Despite the various health, environmental and traffic-related benefits, the uptake of alternative forms of transportation such as walking, cycling and public transport are low.Methods: In response to a growing reliance on motorised transport, the Department for Planning and Infrastructure's (DPI's) Cycling Unit conducts an annual Bike to Work Breakfast to promote cycling as a viable form of transport to work. During this event a short cross sectional survey is distributed to assess the usual cycling behaviours of attendees. Topical issues relating to cycling are also investigated.Results: Results from the 2004 survey indicated that the majority of respondents cycled at least 2-3 times per week (85%) to improve fitness (88%), for enjoyment (70%) and because it was a cost effective means of transport (45%). Most of the respondents (92%) supported the need for more cycle friendly infrastructure such as advanced stop lines at intersections and safety measures such as wearing cycle helmets (85%). These findings were consistent with results from similar surveys conducted between 2000 and 2003.Conclusions: The DPI's Bike to Work Breakfast is a popular event within the cycling calendar that provides the opportunity to gain a snapshot of cycling behaviours and attitudes of cyclists. Prior consultation with the evaluators in the developed of the survey instrument has the potential to investigate barriers and enablers to cycling on a regular basis. Age and gender differences could also be explored

Stabilising effect of α-lactalbumin on concentrated infant milk formula emulsions heat treated pre- or post-homogenisation

peer-reviewedProtein type and/or heat treatment pre- or post-homogenisation can affect the physical stability of infant formulations during manufacture. Previous research has described the use of α-lactalbumin addition in infant formulae, but has not demonstrated the effect of heating pre- or post-emulsion formulation during processing. The objective of this study was to evaluate the effect of both of these parameters. Three batches of model 1st-stage infant formula containing differing whey protein ratios (60:40 whey: casein with α-lactalbumin content 12, 30 or 48% of total protein) were prepared. Each batch was split; one half receiving heat treatment pre-homogenisation and the second half homogenised and then heat treated. Emulsion stability was determined by size exclusion chromatography, SDS-PAGE, particle size and viscosity measurements. There was a significant (P < 0.05) reduction in the formation of large soluble aggregates upon increasing α-lac concentration in emulsions heat treated either before or after homogenisation. Heat treatment of formulations post-homogenisation resulted in a higher (P < 0.05) D.v09 within the particle size distribution; increasing α-lactalbumin concentration to 30 or 48% significantly (P < 0.05) reduced the D.v09 within the particle size distribution in these emulsions. The viscosity of concentrates (55 % total solids) containing the 12% α-lactalbumin, heat treated post-homogenisation, was significantly greater (P < 0.05) than the equivalent emulsion heat treated pre-homogenisation; increasing the α-lactalbumin concentration to 30 or 48% significantly (P < 0.05) reduced viscosity. When the α-lactalbumin content was increased to 48% as a percentage of the total protein, heating before or after emulsion formation had no effect on concentrate viscosity. The findings demonstrate the importance of thermal denaturation/aggregation of whey proteins (and in particular, the ratio of α-lactalbumin to β-lactoglobulin) prior to homogenisation of infant formula emulsions

Graduates of different UK medical schools show substantial differences in performance on MRCP(UK) Part 1, Part 2 and PACES examinations

Background: The UK General Medical Council has emphasized the lack of evidence on whether graduates from different UK medical schools perform differently in their clinical careers. Here we assess the performance of UK graduates who have taken MRCP( UK) Part 1 and Part 2, which are multiple-choice assessments, and PACES, an assessment using real and simulated patients of clinical examination skills and communication skills, and we explore the reasons for the differences between medical schools. Method: We perform a retrospective analysis of the performance of 5827 doctors graduating in UK medical schools taking the Part 1, Part 2 or PACES for the first time between 2003/2 and 2005/3, and 22453 candidates taking Part 1 from 1989/1 to 2005/3. Results: Graduates of UK medical schools performed differently in the MRCP( UK) examination between 2003/2 and 2005/3. Part 1 and 2 performance of Oxford, Cambridge and Newcastle-upon-Tyne graduates was significantly better than average, and the performance of Liverpool, Dundee, Belfast and Aberdeen graduates was significantly worse than average. In the PACES ( clinical) examination, Oxford graduates performed significantly above average, and Dundee, Liverpool and London graduates significantly below average. About 60% of medical school variance was explained by differences in pre-admission qualifications, although the remaining variance was still significant, with graduates from Leicester, Oxford, Birmingham, Newcastle-upon-Tyne and London overperforming at Part 1, and graduates from Southampton, Dundee, Aberdeen, Liverpool and Belfast underperforming relative to pre-admission qualifications. The ranking of schools at Part 1 in 2003/2 to 2005/3 correlated 0.723, 0.654, 0.618 and 0.493 with performance in 1999-2001, 1996-1998, 1993-1995 and 1989-1992, respectively. Conclusion: Candidates from different UK medical schools perform differently in all three parts of the MRCP( UK) examination, with the ordering consistent across the parts of the exam and with the differences in Part 1 performance being consistent from 1989 to 2005. Although pre-admission qualifications explained some of the medical school variance, the remaining differences do not seem to result from career preference or other selection biases, and are presumed to result from unmeasured differences in ability at entry to the medical school or to differences between medical schools in teaching focus, content and approaches. Exploration of causal mechanisms would be enhanced by results from a national medical qualifying examination

Effect of reducing daily herbage allowance during early lactation on composition and processing characteristics of milk from spring-calved herds

peer-reviewedThe study investigated the effects of reducing daily herbage allowance (DHA) from 15.0 to 11.8 kg dry matter per cow (>3.5 cm post grazing sward height) to a spring-calved herd during early lactation on the composition, rennet coagulability and heat stability characteristics of milk during early lactation (EL, 29–70 days in milk, DIM), mid lactation (ML, 78–183 DIM), and late lactation (LL, 205–267 DIM). Samples of milk were taken at approximate 10 d intervals during EL and at 1–3 week intervals during ML and LL. Reducing DHA led to reductions in milk yield, milk solids yield, and concentrations of protein (∼0.22%, w/w) and casein (0.13%, w/w) during EL. Otherwise, it had little effect on milk composition or on the selected processing characteristics in ML, LL or overall lactation. Stage of lactation resulted in comparatively large changes in most compositional parameters, rennet gelation and heat stability

Predictive validity of the UK clinical aptitude test in the final years of medical school:a prospective cohort study

Peer reviewedPublisher PD

Addressing Barriers to Breast Cancer Screening: Where to Intervene to Increase Mammogram Completion Rates

Methods: Study sought to determine if an intervention would aid in increasing mammogram screening rates in the Jefferson Family Medicine Associates practice.https://jdc.jefferson.edu/patientsafetyposters/1061/thumbnail.jp

Grazing of dairy cows on pasture versus indoor feeding on total mixed ration: Effects on low-moisture part-skim Mozzarella cheese yield and quality characteristics in mid and late lactation

peer-reviewedThis study investigated the effects of 3 dairy cow feeding systems on the composition, yield, and biochemical and physical properties of low-moisture part-skim Mozzarella cheese in mid (ML; May–June) and late (LL; October–November) lactation. Sixty spring-calving cows were assigned to 3 herds, each consisting of 20 cows, and balanced on parity, calving date, and pre-experimental milk yield and milk solids yield. Each herd was allocated to 1 of the following feeding systems: grazing on perennial ryegrass (Lolium perenne L.) pasture (GRO), grazing on perennial ryegrass and white clover (Trifolium repens L.) pasture (GRC), or housed indoors and offered total mixed ration (TMR). Mozzarella cheese was manufactured on 3 separate occasions in ML and 4 in LL in 2016. Feeding system had significant effects on milk composition, cheese yield, the elemental composition of cheese, cheese color (green to red and blue to yellow color coordinates), the extent of flow on heating, and the fluidity of the melted cheese. Compared with TMR milk, GRO and GRC milks had higher concentrations of protein and casein and lower concentrations of I, Cu, and Se, higher cheese-yielding capacity, and produced cheese with lower concentrations of the trace elements I, Cu, and Se and higher yellowness value. Cheese from GRO milk had higher heat-induced flow and fluidity than cheese from TMR milk. These effects were observed over the entire lactation period (ML + LL), but varied somewhat in ML and LL. Feeding system had little, or no, effect on gross composition of the cheese, the proportions of milk protein or fat lost to cheese whey, the texture of the unheated cheese, or the energy required to extend the molten cheese. The differences in color and melt characteristics of cheeses obtained from milks with the different feeding systems may provide a basis for creating points of differentiation suited to different markets.This study was funded by the Department of Agriculture, Food and the Marine (Dublin, Ireland) Stimulus fund (11/sf/309), and additionally supported by funding from the Dairy Levy Trust Co-Operative Society Limited (Dublin, Ireland)

The UK medical education database (UKMED) what is it?:Why and how might you use it?

The development of UKMED has not been directly funded by but has received support from the General Medical Council and Medical Schools Council as well as staff time from all participating organisations.Peer reviewedPublisher PD